Individual provider Active NPI

Jordan Colby

  • Dentist
  • San Marcos, CA
National Provider Identifier
1861874471
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
64552 Issued in CA
Practice address
955 Boardwalk
103
San Marcos, CA 92078-2659
Phone
(760) 471-1003
NPI assigned
Jun 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 64552 CA Primary

Addresses

Primary practice location

955 Boardwalk
103
San Marcos, CA 92078-2659

Mailing address

2318 Catalina Cir
286
Oceanside, CA 92056-5330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Z McBride DDS PastSince Jul 1, 2018 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1861874471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 CATALINA CIR",
            "address_2": "286",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920565330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 BOARDWALK",
            "address_2": "103",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782659",
            "telephone_number": "760-471-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBY",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.